Data in healthcare these days can be quite fragmented. Cordoned off into silos, this mish-mash of information acts as a leash on an organization's financial performance that prevents an entity from confidently moving toward risk -- something the industry increasingly values, especially as it moves from fee-for-service to value-based payment arrangements.
Largely, this is due to how healthcare organizations handle their data, often adopting methods that are primarily application-driven. David Nace, MD, chief medical officer at Innovaccer and the former senior vice president and CMO at UnitedHealth Group, said it's easier to get the most out of data by focusing on the data first, and building applications around it.
"All enterprises have data silos," said Nace. "Whether it's a banking institution or government agency. The big problem we have in healthcare, the holy grail, is interoperability -- how do we get data flowing in real time where people can see all of their data?"
The application-first approach is all too common, he said. If an organization needs a nursing documentation tool, or a radiology imaging tool, they generally buy an application.
"Like years ago you or I would have bought Excel as an application," Nace said, "and then they determine what data the application needs, and build the data around that. In this new world -- with Uber, Lyft and Twitter as just three examples -- they build themselves from the ground up using this new framework. It's data-first, not application-first. Once you have all the data, you can solve problems. You can build the applications on top of your data. And those applications will change over time, because you keep innovating and finding different things to do."
A data-first approach becomes an incredibly important facet of connecting disparate data platforms, which is necessary in building a 360-degree view of both clinical and financial performance.
"You need it in real time," he said. "You need it in good quality and then put it into one flexible model that can democratize the data. Most healthcare systems have already made investments in applications, and they don't necessarily want to lose the investment they made. But it's your data -- that data should be applied to any third-party application you have."
Application-first, fragmented data isn't just an issue in healthcare. It's a unique time in history, as the rise of data-first companies, such as Twitter, Uber and Lyft, have increasingly made the application-first approach obsolete, leaving many businesses in many industries grasping for ways to organize and make sense of their patchworks of data. Banks, transportation departments and other businesses and agencies often have a long queue of information-related projects, most of them geared toward solving data problems.
"Healthcare has been a laggard around the adoption of technology," Nace said. "It's been far behind. Financial data is easier because its more uniform, but healthcare still lags behind other industries, and other industries are still struggling with data silos."
There's a clear monetary incentive to getting data right. Healthcare organizations that have leaned on Innovaccer to address tricky data issues have increased the amount of people in their networks, dropped their emergency department visits by an average of 6 percent, cut readmissions by 7 percent, and saved $4 million in the first year of implementation. Some have saved up to $28 million to date.
In the future, Nace sees government and commercial payers continuing to collaborate and move people into risk more quickly -- a trend he sees revving up.
"Data really is the lifeblood of a healthcare enterprise," he said. "Data is critical to what they do. Once you have the data you can generate the insights, and once you have the insights you can take action."
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com